摘要目的 探讨分析诊断级CT图像特征预测食管癌放疗效果的可行性.方法 33例接受调强放疗的Ⅰ-Ⅳ期食管癌患者;治疗期间采用CT-on-rail影像系统获取CT图像,MIM图像系统获取大体肿瘤、脊髓和无照射组织(NIT)的容积、CT平均值、标准差、斜度等影像特征数据,并观察其变化.根据治疗后3个月随访结果将患者分为有效组(完全缓解+部分缓解)24例、无效组(无变化+进展)9例.采用自行设计Matlab软件动态分析组间差异.结果 33例患者的肿瘤容积、CT平均值随照射剂量增加而逐渐减小,有效组、无效组容积和CT平均值分别减少42.46％、21.76％和5.76 HU和3.66 HU,有效组下降幅度较无效组更显著(P＜0.005);无效组的斜度随放疗剂量增加而下降,有效组的斜度变化趋势则相反,两组变化值分别为0.503和-0.450(P=0.034);脊髓和NIT随照射剂量增加无变化.结论 分析放疗期间食管癌患者CT图像的特征数据可能早期预测放疗疗效.

abstractsObjective To investigate the feasibility of assessing the treatment response using diagnostic-quality CT imaging features during radiotherapy for esophageal cancer.Methods Thirty-three patients with stage Ⅰ to Ⅳ esophageal cancer undergoing intensity-modulated radiotherapy were recruited in this study.CT images were acquired using a CT-on-rail imaging system.Imaging data of CT images including gross tumor volume (GTV),the volume of spinal cord and non-irradiated tissue (NIT),CT mean (MCTN),standard deviation,and skewness were collected and analyzed by using MIM image processing system.Patients were divided into the effective group (complete remission and partial remission,n=24) and ineffective group (no change and progression,n=9) based on the outcomes of 3-month follow-up.The imaging data were statistically compared between two groups using the self-designed Matlab software.Results The tumor volume and MCTN of 33 patients were gradually decreased with the increase of radiotherapy dose.The tumor volume and MCTN were decreased by 42.46％ and 5.76 HU in the effective group,more significant compared with 21.76％ and 3.66 HU in the ineffective group (both P＜0.005).The skewness in the ineffective group was decreased by 0.503 with the increasing radiation dose,whereas that in the effective group was increased by-0.450(P=0.034).Spinal cord and NIT did not significantly change with the increasing radiation dose.Conclusion Analysis of the characteristic data of CT images of patients with esophageal cancer during radiotherapy may early predict the clinical efficacy of radiotherapy.